丁螺环酮与艾司西酞普兰联合治疗脑卒中后中重度抑郁的临床观察(1)
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[摘要] 目的：比较丁螺环酮与艾司西酞普兰联用治疗脑卒中后中重度抑郁与单用艾司西酞普兰治疗的疗效及安全性。方法：选择脑卒中后中重度抑郁患者60例，随机分为两组，各30例。研究组采用丁螺环酮与艾司西酞普兰联合治疗，对照组单用艾司西酞普兰治疗，观察疗程均为8周，定期对患者采用HAMD(24项)抑郁量表与TESS副反应量表进行疗效评估。结果：研究组临床疗效总有效率为93.3%(28/30)，显著优于对照组的63.3%(19/30)(χ2=8.91，P=0.031，P<0.05)。两组治疗后HAMD评定，治疗第1周开始较治疗前有统计学意义，且一直持续至观察第8周，研究组与对照组比较亦有统计学意义(P<0.05)。两组治疗期间副反应无统计学意义。结论：艾司西酞普兰联用丁螺环酮治疗脑卒中后抑郁较单用艾司西酞普兰治疗疗效显著，安全性高。
[关键词] 脑卒中后抑郁；丁螺环酮；艾司西酞普兰
[中图分类号] R749.4[文献标识码]B [文章编号]1673-7210(2011)04(a)-080-02
Clinical observation of post-stroke depression by Buspirone combined with Escitalopram
YUAN Fuqiang, MA Zhenwu, YU Hongyan
Department Senile Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, He′nan Province, Xinxiang 453002, China
[Abstract] Objective: To compare the effect and safety of Buspirone combined with Escitalopram and Escitalopram used singly in the treatment of post-stroke depression. Methods: Totally the 60 post-stroke depression patients were randomized into control group (n=30), treated with Escitalopram, and study group (n=30), treated by Buspirone combined with Escitalopram. The observation lasted 8 weeks. The therapeutic effect and safety were evaluated by the positive and negative syndrome scale of HAMD (24 items), and treatment emergent symptom scale of TESS. Results: Total effective rate of the study group was 93.3%(28/30) and with the control group 63.3% (23/30), there was a significant difference (χ2=8.91，P=0.031, P<0.05), and according to HAMD total scores assessment, there was a significant difference between two groups (P<0.05) after the treatment in different weekend. The difference of TESS scores between two groups was not significant. Conclusion: Buspirone combined with Escitalopram is effective and safe in the treatment of post-stroke depression.
[Key words] Post-stroke depression; Buspirone; Escitalopram
脑卒中后抑郁(post-stroke depression，PSD)是脑卒中患者的常见并发症，严重影响了患者生存质量。艾司西酞普兰是一种选择性5-羟色胺(5-HT)再摄取抑制剂(SSRIs)的一种新型的抗抑郁药，药物副作用少，而丁螺环酮也是一种新型的抗焦虑药，主要作用于脑内5-羟色胺1A(5-HT1A)受体的激动，其对抑郁症也有一定的疗效[1]。笔者以丁螺环酮与艾司西酞普兰[2-3]联合应用治疗脑卒中后中重度抑郁与单用艾司西酞普兰作为对照组进行研究，了解和评估丁螺环酮与艾司西酞普兰对脑卒中后中重度抑郁的治疗效果和安全性。
1 资料与方法
1.1 一般资料
60例均为2009年12月～2010年8月新乡医学院第二附属医院的门诊和住院患者 ......
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